Diligent eye care is a requirement for those living with diabetes. Annual eye exams are a key component of ensuring long-lasting eye and vision health.
Many diabetics are completely unaware of the significant way in which diabetes can affect their eyes. The damage diabetes can cause is extensive and often irreversible.
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About Diabetic Eye Disease
Diabetic eye disease is the term used to describe a grouping of separate but related eye diseases which are significantly influenced by diabetes. Most commonly, the term describes the diseases with which diabetes is most closely linked: diabetic retinopathy and diabetic macular edema (DME). However, glaucoma and cataracts also fall under the umbrella term of diabetic eye disease.
It is important to note that while only people with diabetes are at risk of developing diabetic retinopathy and diabetic macular edema, both glaucoma and cataracts can develop in people without diabetes
Diabetic Retinopathy & Diabetic Macular Edema
Retinopathy is the result of fluctuating blood sugar levels eventually damaging the blood vessels in the eye. This damage can trigger bleeding which causes noticeable vision impairment and can lead to partial or total blindness if left unchecked.
Diabetic retinopathy is broken down into two types: non-proliferative diabetic retinopathy (NDPR) and proliferative diabetic retinopathy (PDR). PDR is the more advanced form of the disease and is responsible for most serious vision loss.
DME is an offshoot of retinopathy, with approximately 50% of retinopathy patients also developing DME. Whereas retinopathy is the swelling of the blood vessels in the retina, DME is the swelling of the macula (the part of the retina responsible for central vision). Both retinopathy and DME can cause damage to the macula which reduces vision.
Causes of Retinopathy & DME
Retinopathy and DME are caused by the high blood sugar which often comes as a result of inconsistent and haphazard blood sugar management. This causes the blood vessels in the retina to become damaged, starving the retina of nourishment and stimulating the growth of new blood vessels. These new blood vessels are weak and prone to leaking and bleeding, causing further damage in the process.
More Information About Diabetic Retinopathy
- Non-proliferative diabetic retinopathy – Sharked by enlarged capillaries in the retina that cause dot and blot hemorrhages, and hypoxia or lack of oxygen to parts of the retina. In NDPR, the eye does not grow new blood vessels.
- Proliferative diabetic retinopathy – The more advanced form of the disease, new (and weak) blood vessels grow along the surface of the retina. These weak blood vessels often leak blood and other fluids into the eye, obscuring vision. They are also prone to dying, forming scar tissue that can peel back the retina and cause a partial or total retinal detachment.
- Spots, dots, or other lines (that almost look like translucent strings) in your vision called floaters
- Dark or blurry patches in your vision
- Reduced colour saturation
- Fluctuating vision
- Partial or total vision loss
Early detection and management of retinopathy can reduce the risk of significant vision loss and blindness by as much as 95%.
Controlling diabetes and diligently monitoring blood sugar levels is proven to greatly reduce the progression of retinopathy. Treatment outside of managing blood sugar levels begins as the disease starts to progress to the more advanced variant.
- Panretinal laser surgery – A laser makes up to 2,000 tiny burns on the sides of the retina (but not the macula), causing the abnormal blood vessels to shrink. This surgery can itself have serious implications for vision- we will discuss this in detail with you when needed.
- Anti-VEGF injections – Traditionally used to treat DME, anti-VEGF therapy has also been proven to be effective in slowing the progression of PDR.